Fort Loudoun Medical Center
550 Fort Loudoun Medical Center Dr, Lenoir City, TN · Fsregional · · NPI 1609860659
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Ghs somatosensory testing lower extremit CPT 95926 | not published | not published | $109.94 – $205.70 | 13 |
| Ghs somatosensory testing upper & lower limbs CPT 95938 | not published | not published | $207.94 – $818.07 | 13 |
| Ghs speech-gen aug dev eval iii, st CPT 92608 | $46.86 | $142.00 | $26.92 – $59.95 | 2 |
| Ghs sphenopalatine ganglion block CPT 64505 | not published | not published | $278.49 – $292.41 | 12 |
| Ghs spont nystagmus CPT 92541 | not published | not published | $4.13 – $126.75 | 13 |
| Ghs sp train/fitting sp device - kx CPT 92609 | $55.11 | $167.00 | $55.99 – $125.63 | 2 |
| Ghs st - eval for alt comm CPT 92567 | not published | not published | $14.19 – $35.58 | 13 |
| Ghs strapping shoulder - 29240 CPT 29240 | not published | not published | $120.71 – $126.75 | 12 |
| Ghs st - re-eval for alt comm CPT 92597 | $60.06 | $182.00 | $36.79 – $84.70 | 2 |
| Ghs subcutaneous infus, for therapy ea. add. hr CPT 96370 | $23.76 | $72.00 | $17.39 – $125.00 | 26 |
| Ghs subcutaneous infus. for therapy init 1 hr CPT 96369 | $107.58 | $326.00 | $89.89 – $293.40 | 26 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | not published | not published | $670.54 – $704.07 | 12 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | not published | not published | $368.82 – $387.26 | 12 |
| Ghs tracheostomy emergency - transtracheal CPT 31603 | not published | not published | $1,407.71 – $1,478.10 | 12 |
| Ghs trypsin (fecal) CPT 84488 | not published | not published | $3.29 – $13.21 | 14 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | not published | not published | $223.80 – $234.99 | 12 |
| Ghs tx sp hip disloc abd splnt/trac wo CPT 27256 | not published | not published | $223.80 – $234.99 | 12 |
| Ghs urine, hydroxproline total CPT 83505 | not published | not published | $10.94 – $43.98 | 14 |
| Ghs urine, porphyrins quant CPT 84120 | $13.20 | $40.00 | $6.62 – $36.00 | 26 |
| Ghs vaginal delivery only CPT 59409 | $860.97 | $2,609.00 | $1,174.05 – $3,083.81 | 24 |
| Ghs veeg 12-26 hr intmt mont CPT 95715 | not published | not published | $242.78 – $582.73 | 13 |
| Ghs windowing of cast CPT 29730 | not published | not published | $147.43 – $154.80 | 12 |
| Giardia ag if CPT 87269 | not published | not published | $6.12 – $24.63 | 14 |
| Giardia lamblia antibody CPT 86674 | not published | not published | $6.62 – $26.64 | 14 |
| Gi endoscopic ultrasound CPT 76975 | not published | not published | $53.43 – $227.30 | 13 |
| Gi inhouse confirmation CPT 87045 | $31.35 | $95.00 | $4.25 – $85.50 | 26 |
| Gingivoplasty each quadrant CPT 41872 | not published | not published | $3,008.03 – $3,158.43 | 12 |
| Gi protein loss CPT 78282 | not published | not published | $91.62 – $380.84 | 13 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | not published | not published | $822.88 – $864.02 | 13 |
| Gi trc img intral colon i&r CPT 91113 | not published | not published | $405.24 – $908.48 | 13 |
| Gi trc img intral esophagus CPT 91111 | not published | not published | $822.88 – $864.02 | 13 |
| Gi wireless capsule measure CPT 91112 | not published | not published | $822.88 – $1,274.40 | 13 |
| Gjb2 gene full sequence CPT 81252 | not published | not published | $45.50 – $183.03 | 14 |
| Gjb2 gene known fam variants CPT 81253 | not published | not published | $27.68 – $111.35 | 14 |
| Gjb6 gene com variants CPT 81254 | not published | not published | $15.75 – $63.35 | 14 |
| Glassia injection HCPCS J0257 | $0.74 | $2.25 | $0.87 – $6.15 | 26 |
| Glaucoma scrn hgh risk direc HCPCS G0117 | not published | not published | $14.19 – $63.00 | 13 |
| Glaucoma scrn hgh risk direc HCPCS G0118 | not published | not published | $14.19 – $46.38 | 13 |
| Glaucoma surgery CPT 66150 | not published | not published | $3,750.15 – $3,937.66 | 12 |
| Glaucoma surgery CPT 66155 | not published | not published | $3,750.15 – $3,937.66 | 12 |
| Glaucoma surgery CPT 66160 | not published | not published | $2,093.83 – $2,198.52 | 12 |
| Glaucoma surgery CPT 66170 | not published | not published | $2,093.83 – $2,198.52 | 12 |
| Glove finger flexion right lg xl HCPCS L3912 | not published | not published | $108.07 – $113.47 | 12 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $315.80 | $956.97 | $107.94 – $858.81 | 26 |
| Glucagon hcl 1 mg/ml solution for injection HCPCS J1611 | $284.17 | $861.13 | $81.01 – $775.01 | 26 |
| Glucagon plasma - sendout CPT 82943 | $27.39 | $83.00 | $6.43 – $74.70 | 26 |
| Glucagon tolerance panel CPT 80422 | not published | not published | $20.73 – $83.39 | 14 |
| Glucagon tolerance panel CPT 80424 | not published | not published | $22.73 – $91.41 | 14 |
| Glucagon tolerance test CPT 82946 | not published | not published | $8.00 – $32.16 | 14 |
| Glucose 1 hr post dose CPT 82950 | $15.84 | $48.00 | $2.14 – $43.20 | 26 |
| Glucose-6-phosphate dhydrogenase screen CPT 82960 | not published | not published | $2.72 – $10.95 | 14 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | not published | not published | $1.48 – $5.94 | 14 |
| Glucose blood quantitative CPT 82947 | $12.54 | $38.00 | $1.77 – $34.20 | 26 |
| Glucose body fluid CPT 82945 | $19.80 | $60.00 | $1.77 – $36.00 | 26 |
| Glucose monitoring continual min 72hr pt CPT 95249 | not published | not published | $27.98 – $60.30 | 13 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $29.04 | $88.00 | $5.79 – $79.20 | 26 |
| Glucose tolerance test (gtt) >3 specimens each additional CPT 82952 | $13.20 | $40.00 | $1.76 – $36.00 | 26 |
| Glycopyrrolate 0.2 mg/ml injection solution HCPCS J1596 | $35.54 | $107.71 | $0.29 – $6.13 | 17 |
| Gold sodium thiomaleate inj HCPCS J1600 | not published | not published | $7.39 – $34.07 | 2 |
| Golimumab 12.5 mg/ml intravenous solution HCPCS J1602 | $2,248.37 | $6,813.25 | $9.80 – $6,131.92 | 26 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $61.71 | $187.00 | $8.36 – $168.30 | 26 |
| Gonadotropin hormone panel CPT 80426 | not published | not published | $66.78 – $268.62 | 14 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $61.71 | $187.00 | $8.33 – $168.30 | 26 |
| Gonioscopy CPT 92020 | not published | not published | $31.81 – $126.75 | 13 |
| Goniotomy CPT 65820 | not published | not published | $3,750.15 – $3,937.66 | 12 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,264.04 | $3,830.42 | $163.69 – $3,447.37 | 26 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | not published | not published | $112.91 – $118.56 | 12 |
| Graft bone flex 2.5cm x 5cm grafton-cost per sq cm HCPCS Q4205 | not published | not published | $112.91 – $118.56 | 12 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | not published | not published | $112.91 – $118.56 | 12 |
| Graft hand or finger tendon CPT 26416 | not published | not published | $2,968.60 – $3,117.03 | 12 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $26,706.90 | $80,930.00 | $112.91 – $72,837.00 | 26 |
| Graft jckt xpress 2ml flowable scaffold-q4113-cost per sq cm HCPCS Q4113 | not published | not published | $862.05 – $2,117.35 | 2 |
| Graft nerve adv 3-4x70mm HCPCS C1762 | $3,550.78 | $10,759.95 | $498.75 – $2,137.50 | 17 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | not published | not published | $112.91 – $118.56 | 12 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $976.80 | $2,960.00 | $60.39 – $2,664.00 | 26 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $4,900.50 | $14,850.00 | $112.91 – $7,695.00 | 26 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | not published | not published | $112.91 – $118.56 | 12 |
| Graft tis hmatrix dermis 10x5 -cost per sq cm HCPCS Q4134 | not published | not published | $112.91 – $118.56 | 12 |
| Graft tiss strattice 10x10 frm 10x10cm firm -cost per sq cm HCPCS Q4130 | $33,877.80 | $102,660.00 | $112.91 – $7,389.00 | 26 |
| Graft viashield 2layer amnion patch 2x2cm-cost per sq cm HCPCS Q4211 | not published | not published | $112.91 – $118.56 | 12 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | not published | not published | $112.91 – $118.56 | 12 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $19,965.00 | $60,500.00 | $76.16 – $326.43 | 17 |
| Graft xenmtrx sft rect 19x28cm HCPCS C2625 | $1,958.55 | $5,935.00 | $254.20 – $1,089.45 | 17 |
| Granisetron 1 mg tab HCPCS Q0166 | $19.49 | $59.05 | $3.46 – $62.59 | 17 |
| Granisetron hcl injection HCPCS J1626 | $115.80 | $350.90 | $0.16 – $53.10 | 17 |
| Great toe-hand transfer CPT 26551 | not published | not published | $6,583.38 – $6,912.55 | 12 |
| Great toe with reduction 28495 CPT 28495 | not published | not published | $223.80 – $234.99 | 12 |
| Grfg autol fat lipo 25 cc/< CPT 15773 | not published | not published | $1,871.96 – $1,965.56 | 12 |
| Grfg autol fat lipo 50 cc/< CPT 15771 | not published | not published | $3,215.13 – $3,375.89 | 12 |
| Grfg autol soft tiss dir exc CPT 15769 | not published | not published | $3,215.13 – $3,375.89 | 12 |
| Ground mileage HCPCS A0425 | not published | not published | $628.00 – $704.03 | 2 |
| Group behave couns 2-10 HCPCS G0473 | not published | not published | $25.47 – $35.69 | 12 |
| Group health education CPT 99078 | not published | not published | $198.00 – $198.00 | 1 |
| Group mnt 2 or more 30 mins HCPCS G0271 | not published | not published | $7.72 – $19.61 | 2 |
| Group train without patient HCPCS G0543 | not published | not published | $5.18 – $27.55 | 12 |
| Growth hormone antibody CPT 86277 | not published | not published | $7.08 – $28.49 | 14 |
| Growth hormone panel CPT 80428 | not published | not published | $30.02 – $120.73 | 14 |
| Growth hormone panel CPT 80430 | not published | not published | $50.20 – $234.09 | 14 |
| Growth stimulation gene 2 CPT 83006 | not published | not published | $14.07 – $136.84 | 14 |
| Grp adapt bhv tx by phy/qhp CPT 97158 | not published | not published | $16.69 – $35.69 | 12 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.